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Learner Handoffs Within Clinical Rotations: From the Resident Perspective.

Michael D Fishman1, Katherine L Harriel2, Caroline G Kahane3

  • 1M.D. Fishman is a pediatrics resident, Department of Pediatrics, Boston Children's Hospital and Boston Medical Center, Boston, Massachusetts.

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Learner handoffs (LHs) can improve medical education continuity and patient safety. However, residents identified risks of bias and suggested structured tools to enhance learner development and mitigate challenges.

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Area of Science:

  • Medical Education
  • Qualitative Research
  • Healthcare Systems

Background:

  • Competency-based medical education requires continuous learner assessment.
  • Frequent faculty changes in clinical rotations disrupt educational continuity.
  • Learner handoffs (LHs) are proposed to transfer learner information among supervisors.

Purpose of the Study:

  • To explore pediatric residents' perspectives on learner handoffs.
  • To identify the perceived benefits and challenges of learner handoffs from the learner's viewpoint.
  • To inform the development of structured learner handoff processes.

Main Methods:

  • Qualitative thematic analysis of 8 focus groups with 44 pediatric residents.
  • Data collected from 3 pediatric residency programs of varying size and location (July-December 2021).
  • Independent coding and thematic saturation achieved through consensus.

Main Results:

  • Learner handoffs positively impact learner development, clinical practice, and the learning environment.
  • Benefits include improved team functioning, trust, and patient safety.
  • Concerns identified include the risk of bias and lack of transparency in current LH practices.

Conclusions:

  • Residents see value in learner handoffs but are concerned about bias.
  • A structured, learner-centered LH tool could enhance professional development and address challenges.
  • Future research should define essential LH model components with stakeholder input.